LBP on Medicaid work requirements
Submitted by merenberg on February 19th, 2018
Gov. John Bel Edwards said this week that his administration is "actively working" to develop a work requirement plan for able-bodied Medicaid recipients. The governor's announcement came on the same week that President Donald Trump's administration announced that it would start approving such plans, which had never before been allowed in the Medicaid program. In a letter outlining the new policy, Center for Medicare and Medicaid Services deputy administrator Brian Neele states that work requirements promote health and well-being. However, studies have shown that work requirements may actually decrease work participation by denying people access to health care and add additional expenses to state government. Furthermore, a majority of working-age Medicaid beneficiaries are already working, in school or seeking work. The AP's Melinda Deslatte reports.
"We're looking at people who are able-bodied, and it has to accommodate those who are in work training or education," he said. "We're looking for a requirement that actually make sense." ... The federal guidelines say the administration would consider work requirements for "able-bodied, working-age" Medicaid recipients. States could require alternatives to work, including volunteering, caregiving, education, job training and treatment for a substance abuse problem. The guidance said states should exclude pregnant women, disabled people and the elderly and take into account hardships for people in areas with high unemployment, or for people caring for children or elderly relatives.
The legality of work requirements is being questioned by some lawyers, who say they it is in direct opposition to Medicaid's core mission. Section 1115 of the Social Security Act allows states to diverge from certain Medicaid requirements, but only if these changes "further the objectives" of Medicaid. The Washington Post's Amy Goldstein has more:
[Leonardo] Cuello said the argument that work promotes health is "totally contorted...It's a little like saying that rain causes clouds. It's more that people [with Medicaid] get care, which helps them be healthy and makes them able to work." In a letter Thursday to Brian Neale, the CMS deputy director who oversees Medicaid, the organization said the administration's new policy "entirely ignores the wealth of literature regarding the negative health consequences of work requirements" and was issued without any opportunity for public input.
LBP's Jeanie Donovan weighed in on the issue last year as the Senate was considering a bill to mandate work requirements. The bill was shelved amid strong opposition from health and consumer groups.
67 - percent of Medicaid recipients in Louisiana are children, seniors or disabled. (Source: Louisiana Department of Health)
This article was cross-posted from the Louisiana Budget Project's Daily Dime January 12, 2018. The Daily Dime is a summary of the day's news stories related to the state budget and issues that affect low- and middle-income individuals and families, compiled every business day by Louisiana Budget Project staff. Click here to have the Daily Dime delivered to your inbox.